EONS Magazine Winter/Spring 2019 edition

Technology – Friend or foe?

Lynn Leppla introduces the SMILe project

Towards implementation of an ehealth-powered integrated model of care in allogeneic HSCT

Lynn Leppla

Lynn Leppla

A new approach to follow-up care after allogeneic stem cell transplantation (HSCT) is needed due to an increasing number of long-term survivors in need of comprehensive care needs.

eHealth solutions show promise in improving clinical outcomes in cancer patients, yet successful implementation and sustainability of innovative eHealth supported care models requires proper understanding, including contextual analysis.

To this end, a contextual analysis was carried out as part of the development, implementation and testing of the effectiveness of an Integrated model of care in hematopoietic SteM cell transplantatIon faciLitated by eHealth (known as SMILe) – an App combined with a Care-Coordinator (See video for more on how this works https://vimeo.com/259739507)

Fig 1. Slide showing SMILe prototype elements

Fig 1. Slide showing SMILe prototype elements

This analysis investigated HSTC patients’ and clinicians’ current experiences of follow-up care, their perception of eHealth-enhanced follow-up care and their openness to technology. The University Hospital Freiburg, Germany, designed an approach (single-center explanatory sequential mixed methods) to map out the context and understand patients’ and clinicians’ perspectives on the current follow-up situation and possible eHealth support. A total of 60 patients and 5 clinicians were surveyed and interviewed individually or in focus groups.

Lynn at work

Lynn at work

What did we find?

  • Patients perceive gaps in chronic care delivery, especially in the transition phase from hospital to home.
  • Patients would benefit most from support in recognising, judging and acting upon new symptoms during the first months after HSCT until they become their own experts.
  • Electronic monitoring of the most important parameters combined with automated feedback and care-coordinator support would give patients a feeling of security.
  • (Most importantly) eHealth should never replace human contact. It should be seen as a complementary element to ease transition from hospital to home, ideally supporting decision making, self-management and behavioral performance.

This contextual analysis, combined with the existing evidence, set the stage for the first SMILe prototype which will be tested for the first time in a clinical setting in 2019.

Watch the video at Vimeo: https://vimeo.com/259739507

Lynn Leppla is based at Freiburg University Hospital, Germany.